MEDICARE: TL BILLING AND PRACTICE MANAGEMENT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1760749303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TL BILLING AND PRACTICE MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	PO BOX 27409
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77227-7409
Country	:	US
Telephone Number	:	713-553-3983
Fax Number	:	713-344-1475

Provider Business Practice Location Address
First Line	:	6921 BRISBANE CT STE 110
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7094
Country	:	US
Telephone Number	:	281-313-1414
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	BROOKE EAST
Credential	:
Telephone Number	:	713-553-3983

Provider Enumeration Date	:	04/20/2012
Last Update Date	:	10/26/2023

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